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Related Concept Videos

Pulse rhythm01:30

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
Electrocardiogram01:29

Electrocardiogram

An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
Electrocardiogram Fundamentals01:28

Electrocardiogram Fundamentals

Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin to...
ECG Interpretation of Rhythms01:24

ECG Interpretation of Rhythms

An electrocardiogram (ECG)graphically represents the heart's electrical activity on ECG paper or a monitor.
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage. When...
Holter Monitor: 24-Hour Monitoring01:23

Holter Monitor: 24-Hour Monitoring

Holter monitoring is a continuous electrocardiography (ECG) recording that tracks the heart's electrical activity over an extended period, generally 24 to 48 hours. This noninvasive diagnostic tool detects irregular heart rhythms that may not be captured during a standard ECG performed in a clinical setting.DeviceThe Holter monitor is a portable, small device connected to several electrodes on the patient's chest. These electrodes detect the heart's electrical signals and transmit them to the...
Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...

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Related Experiment Video

Updated: Jul 29, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

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Holter triage ambulatory ECG analysis. Accuracy and time efficiency

D H Cooper1, H L Kennedy, D S Lyyski

  • 1Cardiovascular Research Foundation, St. John's Mercy Medical Center, St. Louis, Missouri, 63141, USA.

Journal of Electrocardiology
|January 1, 1996
PubMed
Summary

Triage ambulatory electrocardiographic (ECG) analysis offers comparable accuracy to conventional methods for detecting ventricular ectopic beats and couplets, but requires careful editing for optimal ventricular tachycardia detection. This automated ECG analysis improves time efficiency in several phases.

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Area of Science:

  • Cardiology
  • Medical Instrumentation
  • Digital Health

Background:

  • Ambulatory electrocardiographic (ECG) monitoring, particularly Holter tapes, is crucial for diagnosing cardiac arrhythmias.
  • Automated analysis systems aim to improve efficiency and accessibility of ECG interpretation.
  • Triage systems in ECG analysis filter interpretable tapes, reserving complex cases for expert review.

Purpose of the Study:

  • To evaluate the clinical validity of a specific manufacturer's triage instrumentation for automated ambulatory ECG analysis.
  • To assess the accuracy and time efficiency of triage analysis for ventricular arrhythmias compared to conventional methods.
  • To identify limitations of automated triage systems in ECG interpretation.

Main Methods:

  • A database of 50 Holter tapes, stratified by ventricular ectopic beat (VEB) frequency, was analyzed using triage, conventional, and full-disclosure hand-count methods.
  • Triage analysis automatically interpreted interpretable tapes, with remaining tapes edited by a cardiovascular technician.
  • Accuracy metrics (sensitivity, positive predictive accuracy, false positive rate) and time efficiency across five phases were compared.

Main Results:

  • Half of the Holter tapes were automatically analyzable by the triage method.
  • Triage analysis demonstrated high accuracy for isolated VEBs (96% sensitivity) and ventricular couplets (92% sensitivity).
  • Triage analysis showed limitations in detecting ventricular tachycardia (VT) runs (48% sensitivity), though accuracy improved significantly (86% sensitivity) with editing.
  • Triage analysis was more time-efficient for machine, analysis, and total time, but required more editing time.

Conclusions:

  • Triage ambulatory ECG analysis is generally accurate for common ventricular arrhythmias but requires careful quality control and editing, especially for detecting ventricular tachycardia.
  • The automated system offers significant time efficiencies but has limitations that necessitate human oversight.
  • Further development and validation are needed to enhance the detection capabilities of automated triage systems for complex arrhythmias.